Survivors of childhood cancer have increased risk of gastrointestinal complications later in life Journal Article
| Authors: | Goldsby, R.; Chen, Y.; Raber, S.; Li, L.; Diefenbach, K.; Shnorhavorian, M.; Kadanlottick, N.; Kastrinos, F.; Yasui, Y.; Stovall, M.; Oeffinger, K.; Sklar, C.; Armstrong, G. T.; Robison, L. L.; Diller, L. |
| Article Title: | Survivors of childhood cancer have increased risk of gastrointestinal complications later in life |
| Abstract: | Background & Aims: Children who receive cancer therapy experience numerous acute gastrointestinal (GI) toxicities. However, the long-term GI consequences have not been extensively studied. We evaluated the incidence of long-term GI outcomes and identified treatment-related risk factors. Methods: Upper GI, hepatic, and lower GI adverse outcomes were assessed in cases from participants in the Childhood Cancer Survivor Study, a study of 14,358 survivors of childhood cancer who were diagnosed between 1970 and 1986; data were compared with those from randomly selected siblings. The median age at cancer diagnosis was 6.8 years (range, 021.0 years), and the median age at outcome assessment was 23.2 years (5.648.9 years) for survivors and 26.6 years (1.856.2 years) for siblings. Rates of self-reported late GI complications (occurred 5 or more years after cancer diagnosis) were determined and associated with patient characteristics and cancer treatments, adjusting for age, sex, and race. Results: Compared with siblings, survivors had increased risk of late-onset complications of the upper GI tract (rate ratio [RR], 1.8; 95% confidence interval [CI], 1.62.0), liver (RR, 2.1; 95% CI, 1.82.5), and lower GI tract (RR, 1.9; 95% CI, 1.72.2). The RRs for requiring colostomy/ileostomy, liver biopsy, or developing cirrhosis were 5.6 (95% CI, 2.413.1), 24.1 (95% CI, 7.577.8), and 8.9 (95% CI, 2.040.0), respectively. Older age at diagnosis, intensified therapy, abdominal radiation, and abdominal surgery increased the risk of certain GI complications. Conclusions: Individuals who received therapy for cancer during childhood have an increased risk of developing GI complications later in life. © 2011 AGA Institute. |
| Keywords: | adolescent; adult; cancer chemotherapy; child; preschool child; school child; major clinical study; busulfan; constipation; diarrhea; liver cirrhosis; side effect; cancer radiotherapy; chemotherapy; gastrointestinal symptom; incidence; cyclophosphamide; melphalan; vincristine; risk factor; carmustine; chlormethine; ifosfamide; lomustine; procarbazine; thiotepa; childhood cancer; pediatric; cancer survivor; self report; adverse outcome; infant; stomach ulcer; newborn; ileostomy; nausea and vomiting; jaundice; colitis; heartburn; abdominal surgery; tumor; liver biopsy; gallstone; esophagus disease; chlorambucil; anus fistula; colostomy; intestine polyp; diverticulosis; indigestion; rectum fistula |
| Journal Title: | Gastroenterology |
| Volume: | 140 |
| Issue: | 5 |
| ISSN: | 0016-5085 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2011-05-01 |
| Start Page: | 1464 |
| End Page: | 1471.e1 |
| Language: | English |
| DOI: | 10.1053/j.gastro.2011.01.049 |
| PROVIDER: | scopus |
| PMCID: | PMC3081911 |
| PUBMED: | 21315721 |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 1" - "Export Date: 23 June 2011" - "CODEN: GASTA" - "Source: Scopus" |
Altmetric
Citation Impact
BMJ Impact Analytics
Related MSK Work